This invention relates to methods and instruments for performing hip arthroplasty, and more particularly to methods for implanting a femoral implant as part of an implantable hip prosthesis.
In one popular method of performing a total hip arthroplasty through two incisions, the femur is prepared by passing instrumentation through a small posterior lateral incision. This posterior incision is similar to the incision made when performing a conventional femoral intramedullary nailing procedure except that the incision is located somewhat more superior. A second, anterior incision is made to facilitate the introduction of instrumentation for preparation of the acetabulum as well as to expose the femur from the anterior side. The surgeon is able to view the femur and resect the femoral head from this anterior side. Access along the femoral axis for reamers and broaches is most readily accomplished, however, through the posterior lateral incision. The surgeon bluntly divides the fibers of the gluteus maximus through the posterior incision to develop a small tunnel through which he may pass the femoral broaches, reamers and, eventually, the femoral implant.
The incision and tunnel must be large enough, of course, to accommodate passage of the full girth of the femoral broach and other instrumentation, and the desired femoral implant. Such a large incision and tunnel can cause damage to the muscle fibers as well as the skin margins by excessive stretching of tissue.